Healthcare Provider Details

I. General information

NPI: 1376419127
Provider Name (Legal Business Name): STEFANIE CAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 S YALE AVE STE 1210
TULSA OK
74136-4241
US

IV. Provider business mailing address

6120 S YALE AVE STE 1210
TULSA OK
74136-4241
US

V. Phone/Fax

Practice location:
  • Phone: 918-888-5211
  • Fax: 918-888-5270
Mailing address:
  • Phone: 918-888-5211
  • Fax: 918-888-5270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number225978
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: